CAJ | 학술논문

目的：探讨不同栓塞剂治疗肝巨大海绵状血管瘤中的疗效。方法2008-2010年经诊断明确的肝海绵状血管瘤30例，行介入栓塞治疗，根据栓塞剂不同分为两组，即平阳霉素碘油乳剂（PLE）联合海藻酸钠微球（KMG）组（A组，15例）及（PLE）组（B组，15例），术后1、3、6、12个月进行CT 检查以评价疗效。结果两组术后成功率均达100%，A、B两组所用PLE剂量分别为（10.9±5.2）ml、（11.4±4.9）ml，两者差异无统计学意义（P>0.05），术后第1、3、6个月复查CT，A组瘤体缩小率在50%以上者为分别为9、11、14例，B组分别为0、3、5例（P<0.05）。术后1周A组患者疼痛较B组明显，差异有统计学意义（P<0.05），术后两组部分患者有轻度肝功能异常，主要表现在转氨酶升高，对症处理后恢复正常，经问卷随访A组满意度较B组高。结论经肝动脉注入PLE治疗肝巨大血管瘤安全、有效， PLE 联合KMG组瘤体缩小主要集中在术后第1、3个月内，见效快，但疼痛较PLE组明显。
목적：탐토불동전새제치료간거대해면상혈관류중적료효。방법2008-2010년경진단명학적간해면상혈관류30례，행개입전새치료，근거전새제불동분위량조，즉평양매소전유유제（PLE）연합해조산납미구（KMG）조（A조，15례）급（PLE）조（B조，15례），술후1、3、6、12개월진행CT 검사이평개료효。결과량조술후성공솔균체100%，A、B량조소용PLE제량분별위（10.9±5.2）ml、（11.4±4.9）ml，량자차이무통계학의의（P>0.05），술후제1、3、6개월복사CT，A조류체축소솔재50%이상자위분별위9、11、14례，B조분별위0、3、5례（P<0.05）。술후1주A조환자동통교B조명현，차이유통계학의의（P<0.05），술후량조부분환자유경도간공능이상，주요표현재전안매승고，대증처리후회복정상，경문권수방A조만의도교B조고。결론경간동맥주입PLE치료간거대혈관류안전、유효， PLE 연합KMG조류체축소주요집중재술후제1、3개월내，견효쾌，단동통교PLE조명현。
Objective To discuss and to compare the curative effects of interventional embolization with different embolic agents in treating giant hepatic cavernous hemangiomas. Methods From 2008 to 2010, a total of 30 cases with clinically proved hepatic cavernous hemangioma were treated with interventional embolization. According to the embolic agents used , the patients were divided into pingyangmycin-lipiodol emulsion mixed with sodium alginate microspheres group(PLE+KMG, group A, n=15) and pingyangmycin-lipiodol emulsion group (PLE, group B, n=15). CT scanning was performed one, 3, 6, 12 months after the treatment to evaluate the curative effect. Results The technical success rate was 100%in both groups. The mean PLE dose used in group A and B was (10.9 ± 5.2) ml and (11.4 ± 4.9) ml respectively, the difference between the two groups was not significant (P > 0.05). CT reexamination performed one, 3, 6 months after the treatment showed that a reduction in tumor volume over 50%in group A was seen in 9, 11 and 14 cases respectively, while in group B it was 0, 3 and 5 cases respectively (P <0.05). One week after the procedure, the degree of pain in patients of group A was more severe than that in patients of group B, the difference between the two groups was statistically significant (P < 0.05). Slight abnormal hepatic function was seen in some patients of both groups, which presented mainly as an elevation of aminotransferase, which returned to normal after symptomatic medication. Follow-up with questionnaire indicted that patients of group A were more satisfied with the treatment than the patients of group B. Conclusion Transhepatic infusion of pingyangmycin-lipiodol emulsion is a safe and effective treatment for giant cavernous hemangioma of the liver. Combination use of pingyangmycin-lipiodol emulsion and sodium alginate microspheres can obviously reduce the tumor size mainly in the first and the third month after the treatment, besides it produces instant clinical effect although the pain is more severe than in patients treated with pure pingyangmycin-lipiodol emulsion.